Causes, symptoms, pictures, and treatment

Intertrigo is a skin condition that causes a rash in skin folds, such as under the breasts, in the groin, or in stomach folds. The rash may be sore or itchy.

It happens when areas of moist skin rub together. Bacteria and yeast can grow in this environment, leading to an infection.

In this article, we describe what intertrigo is, what it looks like, and what causes it. We also cover diagnosis, treatment, and prevention.

Intertrigo is a skin condition that happens when folds of skin chafe against each other.

It usually develops in the inner thighs or armpits, or under the breasts or tummy fold.

Some people may experience yeast or bacterial infections in the folds of skin.

Areas of moist skin rubbing together cause intertrigo. The warm, damp environment makes the skin conducive to irritation and the growth of yeast and bacteria, which can lead to an infection.

While it can happen at any age, intertrigo tends to affect infants, older people, and those with a reduced ability to move around. In babies, it is often called diaper rash. Most cases occur in hot or humid environments and during the summer.

Intertrigo is also more common in adults with incontinence, obesity, diabetes, or a weakened immune system.

Specific health conditions that can contribute to the development of intertrigo include:

Inverse psoriasis

Also known as intertriginous psoriasis, this form of psoriasis develops in the folds of the skin. It can look red and shiny.

Hailey-Hailey disease

Hailey-Hailey disease is a rare genetic disorder that causes skin cells to stick together and breaks down the layers of the skin.

People with Hailey-Hailey disease usually experience blisters and irritations on the neck, armpits, and genitals and in the folds of the skin.

Pemphigus

There are different types of pemphigus, but they all happen when the body’s immune system attacks the healthy cells in the top layer of the skin.

It typically causes blisters in the mouth, nose, throat, eyes, or genitals.

Bullous pemphigoid

A fault in the immune system causes bullous pemphigoid. People with the condition can develop mild, itchy welts or more severe blisters on the skin. These tend to appear on areas of the skin that flex or move.

Intertrigo looks like a red, raw rash on the skin. It may feel sore or itchy, and it can sometimes ooze.

It can develop in any fold of the skin. The most commonly affected areas of the body include:

• the inner thighs
• under the breasts
• in the fold of skin underneath a protruding belly
• the groin
• between the buttocks
• in the webs of the fingers
• in the webs of the toes

Intertrigo may develop in one or more of these places.

It will often be a specialist skin doctor, or dermatologist, who diagnoses intertrigo. They will do this by inspecting the skin and asking a series of questions about the person’s symptoms.

If the dermatologist suspects that a yeast or bacterial infection has developed in the skin fold, they may take a swab and send it to a laboratory for analysis.

An article in the Journal of the Dermatology Nurses’ Association offers the following advice on treating intertrigo:

• Wash the affected area with ketoconazole 1% shampoo, which is available from most drugstores. People should leave it on for 2–5 minutes and then rinse it off.
• Use a hairdryer on a low setting to ensure that the area is completely dry.
• Mix equal amounts of clotrimazole 1% cream (or miconazole 1% cream) and hydrocortisone 1% cream and apply a thin layer to the affected area. People should do this twice a day until the rash is clear, which may take 3–8 weeks.
• Once the rash has cleared, continue to use the ketoconazole 1% shampoo as soap in the affected area at least once a week.
• Dry the skin with a hairdryer after every bath or shower, or whenever it feels particularly damp.

The best way to prevent intertrigo is to keep the area dry. People who experience the condition due to obesity can speak to a doctor about ways to lose weight and reduce the risk of skin complications.

The American Osteopathic College of Dermatology suggest that people prevent intertrigo by:

• placing a wad of absorbent material, such as cotton, in the affected fold to absorb sweat
• using antiperspirants
• washing daily with an antibacterial soap
• dusting the affected area with an absorbent antifungal powder once it is clean and dry

Anyone who finds that the problem keeps coming back should speak to a doctor.

Intertrigo is a skin condition that happens when areas of moist skin rub against each other. It causes a red, raw-looking rash and can lead to yeast and bacterial infections.

It can happen to anyone, but it is most common in babies, older people, individuals with mobility problems, and those with obesity.

People can easily treat the rash at home with over-the-counter creams and lotions. They can also prevent it from coming back by keeping the area clean and dry.

Anyone who experiences multiple incidences of intertrigo should speak to a doctor.

Causes, symptoms, pictures, and treatment

Intertrigo is a skin condition that causes a rash in skin folds, such as under the breasts, in the groin, or in stomach folds. The rash may be sore or itchy.

It happens when areas of moist skin rub together. Bacteria and yeast can grow in this environment, leading to an infection.

In this article, we describe what intertrigo is, what it looks like, and what causes it. We also cover diagnosis, treatment, and prevention.

Intertrigo is a skin condition that happens when folds of skin chafe against each other.

It usually develops in the inner thighs or armpits, or under the breasts or tummy fold.

Some people may experience yeast or bacterial infections in the folds of skin.

Areas of moist skin rubbing together cause intertrigo. The warm, damp environment makes the skin conducive to irritation and the growth of yeast and bacteria, which can lead to an infection.

While it can happen at any age, intertrigo tends to affect infants, older people, and those with a reduced ability to move around. In babies, it is often called diaper rash. Most cases occur in hot or humid environments and during the summer.

Intertrigo is also more common in adults with incontinence, obesity, diabetes, or a weakened immune system.

Specific health conditions that can contribute to the development of intertrigo include:

Inverse psoriasis

Also known as intertriginous psoriasis, this form of psoriasis develops in the folds of the skin. It can look red and shiny.

Hailey-Hailey disease

Hailey-Hailey disease is a rare genetic disorder that causes skin cells to stick together and breaks down the layers of the skin.

People with Hailey-Hailey disease usually experience blisters and irritations on the neck, armpits, and genitals and in the folds of the skin.

Pemphigus

There are different types of pemphigus, but they all happen when the body’s immune system attacks the healthy cells in the top layer of the skin.

It typically causes blisters in the mouth, nose, throat, eyes, or genitals.

Bullous pemphigoid

A fault in the immune system causes bullous pemphigoid. People with the condition can develop mild, itchy welts or more severe blisters on the skin. These tend to appear on areas of the skin that flex or move.

Intertrigo looks like a red, raw rash on the skin. It may feel sore or itchy, and it can sometimes ooze.

It can develop in any fold of the skin. The most commonly affected areas of the body include:

• the inner thighs
• under the breasts
• in the fold of skin underneath a protruding belly
• the groin
• between the buttocks
• in the webs of the fingers
• in the webs of the toes

Intertrigo may develop in one or more of these places.

It will often be a specialist skin doctor, or dermatologist, who diagnoses intertrigo. They will do this by inspecting the skin and asking a series of questions about the person’s symptoms.

If the dermatologist suspects that a yeast or bacterial infection has developed in the skin fold, they may take a swab and send it to a laboratory for analysis.

An article in the Journal of the Dermatology Nurses’ Association offers the following advice on treating intertrigo:

• Wash the affected area with ketoconazole 1% shampoo, which is available from most drugstores. People should leave it on for 2–5 minutes and then rinse it off.
• Use a hairdryer on a low setting to ensure that the area is completely dry.
• Mix equal amounts of clotrimazole 1% cream (or miconazole 1% cream) and hydrocortisone 1% cream and apply a thin layer to the affected area. People should do this twice a day until the rash is clear, which may take 3–8 weeks.
• Once the rash has cleared, continue to use the ketoconazole 1% shampoo as soap in the affected area at least once a week.
• Dry the skin with a hairdryer after every bath or shower, or whenever it feels particularly damp.

The best way to prevent intertrigo is to keep the area dry. People who experience the condition due to obesity can speak to a doctor about ways to lose weight and reduce the risk of skin complications.

The American Osteopathic College of Dermatology suggest that people prevent intertrigo by:

• placing a wad of absorbent material, such as cotton, in the affected fold to absorb sweat
• using antiperspirants
• washing daily with an antibacterial soap
• dusting the affected area with an absorbent antifungal powder once it is clean and dry

Anyone who finds that the problem keeps coming back should speak to a doctor.

Intertrigo is a skin condition that happens when areas of moist skin rub against each other. It causes a red, raw-looking rash and can lead to yeast and bacterial infections.

It can happen to anyone, but it is most common in babies, older people, individuals with mobility problems, and those with obesity.

People can easily treat the rash at home with over-the-counter creams and lotions. They can also prevent it from coming back by keeping the area clean and dry.

Anyone who experiences multiple incidences of intertrigo should speak to a doctor.

diagnostics, clinic, rational external therapy

Large fold dermatosis (CLD) is a group of diseases united according to the principle of selective localization on the skin. This group includes dermatoses that have different etiology and pathogenesis, but have clinical similarities that create difficulties for timely diagnosis and choice of rational therapy.

Downstream, these dermatoses can be divided into acute and chronic, in some of them large folds are selectively affected, while in most cases such dermatoses can manifest as a combined lesion of various parts of the skin and mucous membranes.

DCS often occur with the loss of those personality traits that are characteristic of the localization of the process on smooth skin, scalp, mucous membranes, etc., which creates a deceptive similarity in the clinical manifestations of skin diseases of various etiologies. The complexity of timely diagnosis is aggravated by the localization of the process in closed, sometimes difficult to access areas, false modesty of patients or inattentive examination by a doctor [1].

The skin of large folds has the following individual characteristics:

1. Constantly rubbed and macerated.

2. Hypersecretion of sweat glands increases the pH of the skin folds (the environment becomes alkaline), which affects the microbial flora, leading to the activation, primarily of opportunistic microorganisms [2].

3. Insufficient aeration creates the prerequisites for the transition of opportunistic flora into pathogenic (first of all, this applies to yeast infection, as well as pyogenic coccal flora). In this case, the greatest risk group is made up of patients with diabetes mellitus, patients suffering from impaired thyroid function, etc. [3].

4. The anatomical structure and functions of the sebaceous and sweat glands in large folds also differ in originality, depending on the need to create easier sliding, stretching of the contacting surfaces in order to avoid friction, dryness, and limitation of mobility.

5. Apocrine sweat glands of large folds have relatively short and wide ducts, and their glomeruli, additionally connected by fibrous structures, are deeply immersed in loose subcutaneous fat.

6. The architectonics of collagen and elastic fibers gives a greater ability to stretch the skin of the folds compared to other areas of the skin.

7. The sebaceous glands function with a lesser load, since here the glands have only 1-2 lobules, in contrast to the 3-lobed glands on the scalp, facial skin in the region of the tip of the nose and chin [4].

These factors increase desquamation, desquamation of the stratum corneum of the epidermis, on the one hand, thinning it and making it more elastic, on the other hand, exposing it and making it impossible to serve as a barrier to pathogenic microorganisms and harmful chemicals. It should be noted the influence of various chemicals with water- and fat-soluble properties. Mixing with sebum and sweat, changing their chemical composition, both with external contact and with the penetration of the allergen into the skin, chemicals create conditions for additional irritation of the skin of large folds, which is especially evident in allergic dermatitis, toxicoderma, eczema [5] .

The approach to the treatment of DCS makes it necessary to take into account the localization, etiology and nature of the course of the disease: a combination of edema, maceration with exudation in acute inflammatory processes, dryness, infiltration with possible cracking of the skin in the depth of the fold in the chronic course of dermatosis, easy accession of a secondary infection. All this forces doctors to use step by step external means of drying anti-inflammatory, epithelizing and softening action. At the same time, the appointment of various forms, control over their correct use, inconvenience associated with the use of products that color linen and clothes create difficulties for the doctor and patient.

Currently developed and widely used in external therapy corticosteroid preparations of the company “Schering-Plough” (USA): elocom and triderm in various dosage forms. The therapeutic efficacy and safety of these drugs are very high, and the list of dermatoses in which it is advisable to use these drugs is also diverse.

In this report, we have included dermatoses that differ from each other in etiology and pathogenesis, but with a similar clinical picture, therefore, external therapy with creams seems to be quite justified elokom and triderm .

Elokom contains mometasone furoate as an active ingredient, which is a synthetic corticosteroid with anti-inflammatory, antipruritic and vasoconstrictive properties. Mometasone furoate is one of the safest topical glucocorticosteroids (TGCS) with minimal systemic bioavailability (0.4% for cream and 0.7% for ointment). These qualities are due to the presence of a predominantly extragenomic mechanism of action in mometasone furoate. If the genomic effect that prevails in most other TGCS is the formation of a glucocorticoid-glucocorticoid receptor complex, which in turn activates the expression of genes responsible for the synthesis of anti-inflammatory antigens, then the extra-genomic mechanism recently discovered by researchers includes direct inhibition of pro-inflammatory transcription factors by glucocorticoid-glucocorticoid receptor complexes. antigens. At the same time, the anti-inflammatory effect develops faster, and the effect on the genome is minimized, which determines the high safety profile of the drug elokom .

Triderm contains betamethasone dipropionate TGCS 0.05%, antibiotic gentamicin sulfate 0.1% and clotrimazole 1% as an antimycotic substance. It should be noted that clotrimazole, in addition to its own antifungal action, is able to have an antimicrobial effect against a number of microorganisms, allowing potentiating the action of gentamicin.

Simple contact dermatitis due to physical factors such as friction, pressure, less commonly obligate chemicals is very common. Dermatitis can occur in children, especially at an early age as a variant of diaper rash or the so-called diaper dermatitis. Clinically, the disease manifests itself as a bright inflammatory erythema with clear boundaries, less often with the addition of an exudative component in the form of edema and maceration. A particularly important factor is that powders, water- and oil-shaken creams, which were previously used to treat such manifestations, have now lost their value. Now, after using cream 9 for 2-3 days0029 elokom (a topical steroid approved for use without age restrictions), inflammatory changes can be quickly extinguished and relapses can be avoided if the necessary hygiene measures are observed.

Allergic DKS, which occurs more often under the action of facultative irritants of a chemical nature (cosmetics and perfumes, household chemicals, etc.), is usually accompanied by a clinical picture that is much more pronounced in severity compared to that in dermatosis of other areas of the skin. Erythema, edema, vesiculation in allergic dermatitis, similar to an eczematous process or drug-induced toxicoderma, form a torpid course of the disease when localized in large folds (Fig. 1). Figure 1. Dermatitis. The clinical picture of these dermatoses is dominated by polymorphic rashes grouped into foci without clear boundaries, often spreading to areas remote from the place of contact with the allergen [6]. General desensitizing therapy gives a relatively quick resolution of the process on smooth skin, while in large folds the rash fades more slowly, which is associated with the above features of these zones. In this case, external therapy using cream elokom will be justified and effective. Often, the chronization of the process in microbial, less often true eczema, especially when the affected area is the inguinal-femoral, perianal, and in men the inguinal-scrotal folds, makes it necessary to use cream triderm to prevent the attachment of a secondary infection (microbial and yeast). The combination of antimycotic, antimicrobial and anti-inflammatory effects creates a high therapeutic activity to stop these appearances in a short time, restoring health and aesthetic comfort to patients.

Lesions of large folds by yeast fungi have a rather diverse clinical picture. Arising on the skin under the mammary glands, under the abdomen, in the umbilical and inguinal folds, lesions caused by fungi of the genus Candida and others can manifest as diffuse erythema, micropapular and microvesicular elements. In the latter case, along the periphery of the focus, as a result of the fusion of individual microvesicular elements and their opening, a finely scalloped edge of the exfoliated epidermis is formed, extending beyond the fold, onto smooth skin, and in the depth of the fold, one can see a whitish cheesy plaque as a narrow strip located on the erosive surface (Fig. 2 ).Figure 2. Candidiasis. Subjective sensations in the form of itching, of course, aggravate the course of dermatosis, since in order to stop these sensations, patients resort to more frequent hygiene procedures, the use of alcohol solutions, which give only a short-term effect. Cream therapy triderm yeast intertrigo, especially with the involvement of large folds in the process, allows to achieve clinical recovery in the initial stage of the disease, and with a significant prevalence and prescription of the process, reduce the treatment time, reduce negative subjective feelings.

Selective damage to the inguinal folds is characteristic of true (inguinal) epidermophytosis. This disease, belonging to the group of dermatophytosis, is characterized by initial clinical manifestations in the form of a hyperemic edematous spot in the depth of the inguinal fold or on the lateral surface of the thigh, closer to the fold. The process can begin as one-sided, further taking on a symmetrical character and a tendency to spread to adjacent areas of the skin in the vicinity of the inguinal folds. Peripheral growth at first bright, then acquiring a stagnant edematous spot, is subsequently accompanied by peeling in its central part, with edema, hyperemia and microvesiculation in the peripheral zone – in the growth zone. This gives the hearth a scalloped, often garland-like appearance. Severe itching often transforms into a burning sensation, soreness, especially when rubbed with clothes or washed with soap. It is these pain sensations in the acute stage of the disease that reduce the ability to use traditional external fungicides, which cause additional discomfort. Use of an easily absorbed cream or ointment triderm , which have a delicate texture, the combined action of the anti-inflammatory fungicidal and antimicrobial components allow within 2 days to reduce the inflammatory reaction, get rid of discomfort and provide an opportunity to use irritating concentrated fungicidal agents or combine the further use of ointment triderm with systemic antimycotic drugs up to complete cure.

Similar to inguinal epidermophytosis, mycosis of smooth skin caused by fungus 9 has a picture0029 Tr. rubrum (Fig. 3). Figure 3. Mycosis of smooth skin caused by Tr. rubrum. Erythematosquamous foci predominate with small nodular, rarely vesicular rash along the periphery of the foci. Usually, the growth of the focus with rubromycosis goes from the lower leg to the thigh and only then to the inguinal folds, i.e. in the direction opposite to that of inguinal epidermophytosis.

The stability and capriciousness of the course of the disease in rubromycosis necessitates persistent treatment with local and systemic antimycotic agents, however, in case of an exudative form or in case of complications with eczematization, it is possible to use a cream triderm , which will reduce the risk of transformation of the process into microbial (mycotic eczema).

Streptococcal intertrigo is a relatively rare type of acute streptoderma that affects large folds. It occurs mainly in children, less often in adults, the favorite area is behind the ears, folds of the lateral surface of the neck in newborns. Perhaps the accession of streptococcal impetigo to itchy dermatoses (scabies). The defeat of large folds by streptococcal infection in adults develops against the background of somatic burden – in violation of carbohydrate metabolism, a decrease in the function of the immune system. The conflicts arising from streptococcal intertrigo of large folds, quickly opening as a result of friction, form erosive foci of polycyclic outlines. A significant amount of serous exudate is separated from the surface of erosions, additionally macerating the erosive surface and the skin around the focus. Wet-drying dressings with disinfectant solutions can be successfully replaced with cream triderm with a further transition to ointments with antibiotics and sulfonamides.

Psoriasis of large folds has its own clinical features. This type of psoriasis vulgaris or exudative psoriasis often occurs in patients with obesity, diabetes mellitus, and thyroid pathology. In the folds, bright red plaques with a shiny, as if varnished surface, clearly demarcated from healthy skin, often appear symmetrically; in the depth of the fold along the line of skin tension, painful deep cracks often appear, indicating infiltration in the lesion. As a rule, there is no peeling of the skin in the area of ​​the rash, since the scales are easily torn off due to exudative changes and friction of the contacting surfaces (Fig. 4). Figure 4. Psoriasis. This clinical picture is very similar to yeast, streptococcal diaper rash. To suppress the exudative inflammatory reaction in the first 7-10 days, it is advisable to apply a cream on the lesions, and then an ointment elokom , then switching to absorbable ointments.

Treatment of bullous dermatoses is largely determined by the combination of general therapy, including primarily glucocorticoid hormones, with topical therapy. Since the introduction into practice of dermatologists of TGCS, the treatment of patients with true pemphigus (Fig. 5), Figure 5. True pemphigus (vulgar). bullous pemphigoid (Fig. 6), Figure 6. Bullous pemphigoid. Dermatitis herpetiformis Duhring (Fig. 7) Figure 7. Dermatitis herpetiformis Duhring. became more effective, facilitating the work of the doctor and the patient’s condition. The main feature of this group of dermatoses is the appearance of blisters, and then long-term non-healing erosions. In large folds, epithelialization is especially slow, despite massive steroid hormone therapy. With all varieties of true pemphigus, bullous pemphigoid, benign familial pemphigus Gougereau-Hailey-Hailey (Fig. 8) Figure 8. Gougerot-Hailey-Hailey disease. the selection of external medicines presents significant difficulties [7].

Currently, cream and ointment triderm or elocom can be used as initial, and in some cases basic external therapy. So, for a long time, it is possible to quite successfully maintain a stable remission in patients with benign familial pemphigus Gougereau-Hailey-Hailey, recommending them to take restorative agents in combination with the external use of cream triderm .

Thus, the introduction of various dosage forms into the practice of dermatologists triderma and elocoma with unique properties of GCS molecules and a balanced composition of active substances made it possible to determine the choice of external agents for the treatment of DCS in favor of these drugs. Their pharmacological properties and therapeutic profile allow the practitioner to make an informed choice in solving the problem of “efficacy or safety?”, which always arises when it is necessary to prescribe TGCS therapy, including in children.

Yeast infections: diseases, treatments and drugs

Where can I buy?

Encyclopedia

Fungus

Skin and/or mucous membrane lesions caused by yeast fungi are called yeast infections.

The author of the article

Moshkova Elena Mikhailovna

Dermatovenereologist, head of the KDO for the provision of paid services, St. Petersburg State Budgetary Institution of Health “City Dermatovenerologic Dispensary”, St. Petersburg.

What yeast-like fungi cause disease in humans

Human skin is normally inhabited by both bacteria and fungal microorganisms. In small quantities, they are part of the normal microflora of the skin. Yeasts and yeast-like fungi can also live on the skin without causing any skin disease. However, if adverse factors occur (decreased immunity, impaired microflora), fungi begin to actively multiply, their number increases and leads to the development of the disease.

How is skin fungus treated? Watch in a two-minute video with Doctor of Medical Sciences, Professor of the Russian Academy of Sciences Olga Borisovna Tamrazova

Fungi of the genus Malassezia

Yeast-like fungi of the genus Malassezia – the cause of skin dermatosis: seborrheic dermatitis and versicolor (pityriasis) versicolor 90 130 . Approximately 20% of people experience occasional cases of seborrheic dermatitis. And 10% of the population suffers from multi-colored (pityriasis) lichen ³ .

Fungi of the genus Candida

Yeast fungi of the genus Candida – causative agents of candidiasis of the skin, mucous membranes and internal organs. Fungi of the genus Candida are conditionally pathogenic microorganisms, for the existence of which the presence of oxygen in the environment is an optional condition. This explains the possibility of candidiasis of internal organs.

Up to 30-50% of the population carry Candida on their skin. This type of fungus can colonize the mucous membrane of the mouth, intestines, and the genitourinary system.

How fungi of the genus Candida affect human health

Cause itching and dry skin

Provoke the appearance of a white coating on the tongue and bad breath

Contribute to the occurrence of vaginal candidiasis

Affect the feet

900 02 Of the 150 existing species of Candida, 20 species are the causative agents of candidiasis . Most often, Candida albicans, C.tropicalis, C.parapsilosis, C.glabrata ¹ are found in patients.

Skin may show C. albicans, C. parapsilosis, C. guillermondii, C. kefyr ¹ . However, skin candidiasis usually develops due to the presence of Candida albicans , other types of Candida cause skin lesions much less frequently ¹ .

The cause of candidiasis of the genitourinary system in almost 90% of people is C. albicans, in 10% – C. krusei, C. glabrata and others ¹ .

Locations of yeast infections. Symptoms

Seborrheic dermatitis

Seborrheic dermatitis most often occurs on the face and scalp. But the process can be widespread and localized in other seborrheic areas of the body (skin of the back, chest). Rashes are represented by pink spots with peeling on the surface. Sometimes the inflammation is so severe that itching and excessive moisture of the skin (weeping) appear. Often the only manifestation of seborrheic dermatitis is dandruff.

Pityriasis versicolor (pityriasis)

With versicolor versicolor, there is no skin inflammation, so patients are only concerned about the aesthetic component of dermatosis. Spots up to 1 cm usually appear on parts of the body with excessive sweating. The color of the rashes can vary from beige to pink, over time the spots merge into large foci.

Candidiasis of the skin and oral mucosa

Candidiasis of the skin often occurs in the interdigital, axillary, inguinal folds, on the skin under the mammary glands, the fold of the abdomen.

Large fold candidiasis

Large fold candidiasis Doctors also call Candida intertrigo ² . At the bottom of the fold, small bubbles appear, which open up, exposing bright pink with a bluish tinge of skin erosion. Over time, defects in the upper layer of the skin increase in size, merge and can completely spread to the entire surface of a large fold. The erosive surface is wet with a lacquer sheen. A whitish coating may be present. On the periphery of candidal foci, screenings can be found – islands of skin with small vesicles, pustules or small erosions.

Candidiasis of the interdigital folds of the hands often occurs in housewives, catering workers. The predisposing factor is constant contact with water. Often only one interdigital fold on the “working” hand is affected. There is redness, itching, there may be cracks.

Smooth skin candidiasis

Smooth skin candidiasis is more often a complication of an underlying dermatological disease, such as atopic dermatitis or due to the spread of a fungal infection from the skin of large folds.

Candidiasis of the nail folds and nails

Redness, swelling, pain appear at the site of the fungus penetration into the skin of the periungual fold. When pressing on the periungual roller, there are no purulent compartments, in contrast to inflammation of a bacterial nature. And brownish transverse grooves appear on the nail plate, the nail thickens, loses its luster.

Urogenital candidiasis

This disease does not apply to infections that are sexually transmitted ² .

In men, candidal balanitis, balanoposthitis and urethritis are more common.

Men report the following symptoms: ³

• Redness, whitish coating, swelling, itching, burning in the area of ​​the glans penis
• Painful urination and intercourse

See how thrush is treated in a short video by professor, doctor of medical sciences, Shikh Evgenia Valerievna

Vulvovaginal candidiasis (thrush) occurs in women – Candida fungi damage the mucous membrane of the external genitalia and vagina.

More than 70% of women have had an episode of urogenital candidiasis at least once in their lives. And 15% of them had repeated episodes of this disease ³ .

Women note: ³

• White cheesy discharge from the genital tract
• Itching, burning
• Painful urination and intercourse

Predisposing factors for yeast infections

Predisposing factors for yeast infections: ³

• Long-term antibiotic therapy
• Taking anticancer drugs (cytostatics)
• Uncompensated diabetes mellitus
• Immunodeficiency
• Hormonal disorders

Predisposing factors for skin candidiasis include: prolonged contact with water, skin abrasions, excess weight. For the development of oral candidiasis – traumatization of the mucous membrane, for example, when wearing dentures, braces.

Diagnosis of yeast infections

Diagnosis of skin candidiasis is based on the clinical picture of the disease. The doctor may additionally prescribe a skin scraping test for the presence of Candida fungi.

In the diagnosis of urogenital candidiasis, great importance is given to microscopic and cultural methods with the determination of the type of fungus of the genus Candida and its sensitivity to antifungal drugs ³ . And with the help of special test systems, you can detect DNA fragments of the causative agent of urogenital candidiasis.

Diagnosis of diseases caused by fungi of the genus Malassezia is based on examination of skin manifestations, dermatoscopy, examination of skin scrapings for fungi, determination of the Besnier phenomenon (peeling of the rash when scraped with a fingernail or spatula) and Balzer’s test (5% alcohol solution of iodine is applied to the affected area with Entrapment of healthy skin.Increased staining of the rash compared to areas of healthy skin indicates the presence of fungi of the genus Malassezia).

Treatment of yeast infections

Treatment of candidiasis of the skin consists of:

1) Use of topical antifungals in the form of cream/ointment, solution, spray

3) Elimination or correction of provoking factors

Treatment of urogenital candidiasis consists of:0003

2) Prescription of anti-allergic drugs

3) Vitamin therapy

(In some cases, immunomodulatory drugs are recommended)

, creams, ointments) and for oral administration (tablets, capsules). Most often, it is possible to solve the problem with external antifungal agents. However, with widespread rashes, severe persistent course, drugs are prescribed for oral administration

The use of antiseptic or antibacterial drugs when connecting a bacterial infection to the weeping areas of the skin

of the use of combined drugs containing anti -inflammatory hormone, antibiotic and antifungal components, if skin soreness occurs

for candidiasis of the skin, seborrheic dermatitis, multi -colored) external antifungal medicines: sertaconazole, clotrimazole, ketoconazole, terbinafine. For example, appointment Zalain ^® cream 2% (sertaconazole) promotes healing better than other drugs (versus clotrimazole) ⁵ .

Sertaconazole-based cream (Zalain®) for yeast infections

Sertaconazole-based products (Zalain ^® ) are available in the form of suppositories and cream.

With local use of Zalain ^® cream for two weeks, the components of the drug are not detected in the blood and urine, which indicates a high safety profile of the drug ⁷ .

Sertaconazole has a triple action: it prevents the growth and reproduction of fungi, promotes their death, and also prevents the transition of fungi from a passive form to a pathogenic one (only for fungi of the genus Candida) ¹⁵ .

Instruction

Zalain ^® Yeast Infection Cream

How to use Zalain Cream ^®

In case of skin candidiasis, seborrheic dermatitis, pityriasis versicolor Zalain ^® cream is applied 2 times a day in a thin layer covering healthy skin for 2-4 weeks ⁶ .

Topical and systemic antifungal therapy may be indicated for the treatment of urogenital candidiasis.

Urogenital candidiasis in men can be treated externally:

• Zalain ^® cream is applied 2 times a day in a thin layer for 14 days ⁶ .

Triple effect: antifungal, antipruritic, anti-inflammatory

Used 1-2 times a day

Where to buy Zalain ^® Yeast Infection Cream

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Zalain ^® Suppositories

Sertaconazole-based cream (Zalain ^® ) for the treatment of fungal infections al tablets or suppositories (suppositories).

Doctors also recommend vaginal suppositories based on sertaconazole (Zalain ^® ). One suppository is inserted into the vagina 1 time. The use of 1 vaginal suppository is explained by the fact that sertaconazole has a high lipophilicity – it dissolves well in lipid (fat) cell structures. Due to this, the drug remains in the vaginal mucosa for a long time (7 days) at a therapeutic concentration, having a triple mechanism of action on Candida fungi. For women, this prescription of the drug is very convenient.

Unlike other drugs for the treatment of urogenital candidiasis, the effect of Zalain ^® suppositories is observed with a single application of ⁷ . If necessary (maintenance of clinical symptoms), treatment can be repeated after 1 week ⁷ . The doctor may recommend Zalain ^® suppositories to pregnant women if necessary.

The use of specially adapted intimate hygiene gels helps maintain a healthy microflora of the vulva and resist infections.

Only 1 suppository per course

Local effect of the drug

Absorption of sertaconazole into the bloodstream does not occur ¹³

Can be used during pregnancy and lactation*

Where to buy Zalain ^® Candles

Instruction

Why is 1 candle valid for 7 days?

Zalagel ^® Intim

Antiseptic properties of components Zalagel ^® Intim

Zalagel ^® Intim gel-soap, gently cleanses the skin of the intimate area, has a calming effect ohm and helps to reduce the feeling of discomfort.

U Zalagel ^® Intim Slightly alkaline pH (8-9), creating a destructive environment for fungi of the genus Candida (causative agents of thrush). The betaine component, which is part of the gel, prevents dryness of the intimate area, maintains the physiological balance of the skin and mucous membranes.

Gently cleanses the intimate area

Creates a destructive environment for fungi of the Candida genus

Protects the female genital organs from infections

Tea tree oil in the composition of the product has an antibacterial and antiviral effect

Reduces itching and irritation 9000 3

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Instruction

Answers to questions

How to understand that thrush has become chronic?

Answer: Four or more episodes of thrush per year are in favor of chronic recurrent urogenital candidiasis.

How long does the treatment for versicolor take?

Answer: Treatment of multicolored lichen, as a rule, consists in the appointment of external antifungal therapy. The duration of treatment is selected individually and usually lasts at least 2 weeks.

Is it possible to wet the skin with candidiasis of the folds?

Answer: In the acute period of the disease, until the skin process stabilizes, it is necessary to limit contact with water.

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Sources

1. Russian clinical guidelines.
2. Textbook “Skin and venereal diseases” edited by O.L. Ivanov., 2010.
3. National Guide to Dermatovenereology edited by prof. Yu.S. Butova, acad. RAMS Yu. K. Skripkina, prof. O.L. Ivanov.
4. Clinical guidelines of the Russian Federation, Urogenital candidiasis 2019.
5. Efficacy and safety study of Zalain® 2% cream in the treatment of skin mycoses. IG Sergeeva, Yu. M. Krinitsyna Novosibirsk State University.
6. Register of Medicines of Russia, official instructions for the active substance Sertaconazole.
7. Register of Medicines of Russia, official instructions for Zalain® 2% cream.
8. Register of medicines of Russia, official instruction Zalain 300 mg, vaginal suppositories.
9. RMJ No. 9, 2015. “Vulvovaginal candidiasis. The use of Zalain in clinical practice. E. S. Vanke, N. S. Vanke.
10. Mondello F, De Bernardis F, Girolamo A, Cassone A, Salvatore G. In vivo activity of terpinen-4-ol, the main bioactive component of Melaleuca alternifolia Cheel (tea tree) oil against azole-susceptible and -resistant human pathogenic Candida sp. BMC Infect Dis. 2006;6:158.
11. Hammer KA, Carson CF, Riley TV. In vitro susceptibilities of lactobacilli and organisms associated with bacterial vaginosis to Melaleuca alternifolia (tea tree) oil. Antimicrob Agents Chemother 1999;43:196.
12. Pena EF. Melaleuca alternifolia oil. Its use for trichomonal vaginitis and other vaginal infections. Obstet Gynecol 1962;19:793-5.
13. Astani A, Reichling J, Schnitzler P. Comparative study on the antiviral activity of selected monoterpenes derived from essential oils.